MID-AMERICA BOUNDERS

                                                                   
      PRESIDENT                                                                                                                VICE-PRESIDENT
    Steve Rittenhouse                                                                                                       Jerry Hardacre
    Rittenhouse2013@outlook.com                                                                                   jhard1138@gmail.com
  
    SECRETARY
                                                                                                              TREASURER
    Carol Hardacre                                                                                                            Jolly Ann Whitener
    cmh1142@gmail.com                                                                                                   jawhit6@gmail.com

                                                         
MEMBERSHIP APPLICATION


    Pilot’s Name_________________________________________________________

    Co-Pilot’s Name______________________________________________________

    Street Address_______________________________________________________

    City________________________________________State____Zip_____________

    Home Phone_______________________Cell Phone_________________________

    BOA Number________________E-mail ___________________________________

    Birthday: Pilot______________Co-Pilot_____________Anniversary______________
                                   mm/dd                                   mm/dd                                    mm/dd

      Year of Bounder_____________Model_______________________Length_________


    ANNUAL DUES: $5.00.  All  dues are payable in May of each year.  

    Please send completed form and check for dues to Jolly Ann Whitener, Treasurer, 10 Oak Hollow Drive,  
    St. Peters, MO, 63376.   Make your check payable to Mid-America Bounders.

    Thank you and welcome to Mid-America Bounders.  

                                                                                                          Steve Rittenhouse, President